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Wasatch Functional Medicine
Primary Care Nurse Practitioner in South Ogden, Utah
NPI 1396499414

Wasatch Functional Medicine is a Primary Care Nurse Practitioner based in South Ogden, UT and is specialized in Primary Care. Wasatch Functional Medicine practices in South Ogden, UT. The NPI Number for Wasatch Functional Medicine is 1396499414 and holds a License No. (Utah).

The current practice location address for Wasatch Functional Medicine is 5711 S 1475 E Ste 201, South Ogden, UT and can be reached out via phone at 801-332-9034. You can also correspond with Wasatch Functional Medicine through the mailing address at 5711 S 1475 E STE 201, SOUTH OGDEN, UT - 84403-5185 (mailing address contact number: 801-332-9034).

Location: 5711 S 1475 E Ste 201, South Ogden, UT, 84403-5185
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1396499414
Provider Name
Wasatch Functional Medicine
Credential
Provider Entity Type
Organization
Address
5711 S 1475 E Ste 201, South Ogden, UT, 84403-5185
Phone Number
801-332-9034
Fax Number
Provider Enumeration Date
02/08/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
5711 S 1475 E Ste 201
City
South Ogden
State
Utah
Zip
84403-5185
Phone Number
801-332-9034
Fax Number
person
Provider Business Mailing Address Details
Address
5711 S 1475 E Ste 201
City
South Ogden
State
Utah
Zip
84403-5185
Phone Number
801-332-9034
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
363LP2300X
License No.
()
Definition
Definition to come...
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